The Epidemic of Being Overweight and Undernourished

It sounds contradictory, but a significant number of people in the United States today are simultaneously under- and overnourished. How can that be? If you’re significantly overweight, surely you can’t be malnourished, right?

As a former overweight person myself, a registered dietitian who has worked with many people on weight loss issues, and an epidemiologist who studies the science of chronic disease and body weight regulation, I know firsthand that it’s all too easy to be both overweight and malnourished.

The key to understanding this paradox is to understand the difference between macro- and micronutrients. Macronutrients provide the body with energy in the form of calories. Think carbohydrate, protein, and fat. There’s also alcohol, which isn’t an ideal source of calories, but which provides them nonetheless. Being a fan of a nightly glass of wine or a beer, I’d be remiss if I didn’t mention that alcohol provides calories! One gram of alcohol provides 7 calories. This means that in terms of caloric density, your drink is roughly halfway between protein and carbohydrates (4 calories per gram) and fat (9 calories per gram).

Tiny Nutrients, Enormous Benefits

Micronutrients are indeed “micro,” meaning that we need them in small quantities for good health. This includes vitamins, minerals, and phytonutrients, which are non-vitamin/non-mineral plant nutrients. Examples include carotenes and flavonoids. Vitamins and minerals are vital for life – it’s right in the name – vitamins. Without them, we’d end up with a deficiency, and eventually, a deficiency of essential vitamins and minerals can lead to death. Fortunately, in this country, severe vitamin and mineral deficiencies are uncommon. Unfortunately, they are very common in parts of the developing world (I’ll be revisiting this important issue in a future post).

Phytonutrients are different than vitamins and minerals. For one thing, there are thousands of them, compared to just a few dozen essential nutrients. Many phytonutrients are found in vegetables and fruit, and they give these foods their bright red, yellow, purple, green, and orange colors. Most of us are familiar with the phytonutrient beta-carotene, the nutrient that makes carrots and sweet potatoes orange. Other important phytonutrients hide inside whole grains, beans, and nuts.

Unlike vitamins and minerals, phytonutrients aren’t vital for life: you won’t die of a beta-carotene deficiency. But if you don’t get enough phytonutrients, you can have major health problems, which can contribute to difficulty losing weight, and difficulty maintaining weight loss.

What’s the Connection?

Most people don’t give much thought to micronutrients and body weight. Many people figure if it’s not a calorie, it doesn’t matter. The truth is more complex. Sure, calories are one key to weight loss. But dig a little deeper, and you’ll see how adding in the right foods, rich in micronutrients, will aid weight loss, help your body function better, and may even help keep overeating in check. And this is no “diet.” This is how you want to eat. For the rest of your life.

Stronger and Leaner

Phytonutrients appear to help people maintain muscular strength, lean body mass, and muscle function. And if there’s one thing that anyone who’s tried to lose weight understands, it’s that more muscle means more calorie burning, even when you’re not moving. Who knew an apple, a blueberry, green tea, or broccoli could fuel your muscles?

Better Body Chemistry

Many obesity experts now consider obesity to be a state of chronic, low-grade inflammation. This matters a lot if you’re trying to lose weight, because inflammation makes it harder for you to shed fat and much harder for you to build lean, healthy muscle. It’s a vicious cycle: carrying extra body fat promotes inflammation, and inflammation makes it harder to lose weight.

Phytonutrients dampen inflammation. By including plenty of phytonutrient-rich, anti-inflammatory foods in your diet, you fight the low-grade inflammation that results from being overweight and that may be contributing to staying overweight. By dampening inflammation, phytonutrients appear to improve body chemistry, and improve the odds of weight loss success.

Less Overeating

If that’s not enough to convince you to change your dieting ways, consider this: noted nutrition experts now suspect that when we’re overnourished in terms of calories, but undernourished in terms of micronutrients, our bodies have a harder time judging how much food we truly require to satisfy nutritional needs.

We have basic needs for micronutrients – vitamins, and minerals, in particular, but likely phytonutrients, as well. Our bodies will tell us to keep eating until we meet those basic needs. If you eat foods that are low in micronutrients, which not surprisingly includes many “diet” foods, you need to eat more of them to reach the point where your body senses that you’ve gotten enough micronutrients.

Better Gut Health

The human “microbiome” is a hot topic right now. The microbiome refers to the collection of bacteria, fungus, and yes, even viruses, that reside in and on our body. These microbes appear to contribute significantly to health, and this is particularly true for gut health. In fact, the latest research has shown that some microbes in the gut may contribute to obesity, while others help keep us lean. But it’s a chicken and egg thing… which came first? Is a poor diet of unhealthy processed food the cause of “obesity-inducing” microbes? Or are “obesity-inducing” microbes present in higher numbers in the guts of some people, and this is what contributes to obesity, and inability to lose weight and keep it off?

The latest research on this topic was presented on March 5, 2015, at the 97th Annual Meeting of the Endocrine Society in San Diego. Researchers studied people who had recently undergone bariatric surgery – the type of surgery used to induce rapid and dramatic weight loss in people who are significantly overweight (obese). Those people with the highest proportion of gut microbes that produce methane and hydrogen had the least weight loss. The researchers speculate that these methane-producing gut bacteria may be preventing or slowing down weight loss after bariatric surgery.

Other studies have shown that overweight and obese people have different combinations and numbers of specific gut bacteria compared with “lean” people. When you transplant microbes from obese people into “germ-free” mice, they put on weight, but the mice did not put on weight if transplanted microbes came from a lean person. Further, the “lean” bacteria can crowd out the “obese” gut bacteria, which prevents the mice from gaining weight… but only if the mice also ate a healthy diet.

Consider all of these facts together, along with the known gut health benefits of whole plant foods, and it makes sense that these foods can nourish our “lean” bacteria. These foods also may limit the number of “obesity-contributing” bacteria in our digestive tracts, helping us maintain a healthier body weight.

Go Low on the Food Chain

In order to nourish your body properly, you need to eat real food, not count calories. Eating “low on the food chain” gives your body the micronutrients it needs to build muscle, keep fat-promoting inflammation in check, and help you minimize the chances of overeating and bingeing. Of course, much of managing body weight is emotional, psychological, and mental. We know that binge eating disorder (BED) is a real medical condition, and using food to cope is very, very common. No amount of healthy eating will “fix” obesity without getting the emotional help and support you need.

However, once you begin working with a qualified mental health professional to address these very important mental health issues, food choices can help you move closer to your goal of a healthy, happy body, regardless of whether you shed a single pound. Yes, I’m a firm believer that everyone deserves to be healthy, and am a supporter of the Health at Every Size approach to wellness. Beating yourself up for “failing” diets is the last thing you need to do. Further, we live in a toxic food environment; people don’t fail diets, our toxic food environment – in which a bag of chips is cheaper than a bag of apples – fails people!

Now, getting back to eating “low on the food chain…” this means eating mostly whole, unprocessed, plant foods. The closer a food is to its natural form, or what it looks like when it comes out of the ground or off the tree or vine, the more micronutrients it contains. It’s also helpful, of course, that these foods tend to have the fewest calories per amount or volume of food. You get more micronutrients with fewer calories – a win-win all around.

I’m living proof this approach works, and I “walk the walk” every day. At my heaviest, I carried about 50 extra pounds on a 5’4” frame, which I lost for good about 14 years ago to reach a healthy body mass index (BMI) of 21.

Work with the Plate

To best understand the proportions of different phytonutrient-rich foods you need, visualize a typical round plate. Divide that into quarters. Three of those quarters should be filled with plant foods. Keep the balance tipped toward eating mostly vegetables, followed by slightly less fruit, and a very small amount of whole grains. It’s not that I don’t love whole grains, I do! However, between the bread, the bagels, and the cereal, most Americans do not need to be encouraged to eat more grains, whole or otherwise.

The other one-quarter is left for lean protein. Focus on plants – legumes (beans, peas, chickpeas), nuts, and seeds for most of your protein. Eat fish if you’d like, a couple of times per week.. Enjoy organic, free-range/grass-fed chicken, beef, or pork twice per week at most. And if you have a sweet tooth, save room in that last quarter for dessert!